Healthcare Provider Details

I. General information

NPI: 1396942652
Provider Name (Legal Business Name): FARRELL AND SCHAEFER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 08/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11055 LITTLE PATUXENT PKWY SUITE 107
COLUMBIA MD
21044-2896
US

IV. Provider business mailing address

11055 LITTLE PATUXENT PKWY SUITE 107
COLUMBIA MD
21044-2896
US

V. Phone/Fax

Practice location:
  • Phone: 410-964-8777
  • Fax: 410-964-0894
Mailing address:
  • Phone: 410-964-8777
  • Fax: 410-964-0894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER REAGAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-864-8777